Abstract
OBJECTIVE: To evaluate the efficacy and combined application value of contrast-enhanced ultrasound (CEUS) and ultrasound elastography (USE) in diagnosing early hepatocellular carcinoma (HCC) in patients with liver cirrhosis. METHODS: A total of 250 patients with cirrhosis, who were retrospectively analyzed between March 2021 and June 2024, were divided into an HCC group (n = 108) and a non-HCC group (n = 142). All patients underwent CEUS and USE examinations. Quantitative parameters such as peak intensity (PI), arrival time (AT), liver stiffness, and shear wave velocity (SWV) were analyzed. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves. RESULTS: The diagnostic accuracy of CEUS and USE alone was 84.0% and 84.8%, respectively, while their combined use increased the accuracy to 92.4% (P<0.05). CEUS demonstrated a higher sensitivity (87.0% vs. 78.7%), while USE had better specificity (89.4% vs. 81.7%). Among the quantitative parameters, the area under the curve for PI was 0.955, and for SWV, it was 0.988. The combined detection rate for small HCC (≤1 cm) increased from 66.7-72.2% with either method to 83.8%, and diagnostic accuracy for patients with Child-Pugh class A reached 94.1%. CONCLUSION: The combination of CEUS and USE significantly enhances the diagnostic accuracy for early-stage HCC in cirrhotic patients, particularly for those with small HCC and early cirrhosis. Quantitative parameter analysis offers an objective basis for optimizing screening strategies.